Amputation in Diabetic Foot Ulcer and Infection

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The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson's disease using inertial sensor

This study aimed to evaluate the effect of levodopa on the phase coordination index (PCI) and gait asymmetry (GA) of patients with Parkinson's disease (PD) and to investigate correlations between the severity of motor symptoms and gait parameters measured using an inertial sensor. Twenty-six patients with mild-to-moderate-stage PD who were taking levodopa participated in this study. The Unified Parkinson's Disease Rating Scale part III (UPDRS III) was used to assess the severity of motor impairment. The Postural Instability and Gait Difficulty (PIGD) subscore was calculated from UPDRS III. Patients were assessed while walking a 20-m corridor in both "OFF" and "ON" levodopa medication states, and gait analysis was performed using inertial sensors. We investigated the changes in gait parameters after taking levodopa and the correlations between UPDRS III, PIGD, and gait parameters. There was a significant improvement in PCI after taking levodopa. No significant effect of levodopa on GA was found. In "OFF" state, PCI and GA were not correlated with UPDRS III and PIGD. However, in "ON" state, PCI was the only gait parameter correlating with UPDRS III, and it was also highly correlated with PIGD compared to other gait parameters. Significant improvement in bilateral-phase coordination was identified in patients with PD after taking levodopa, without significant change in gait symmetricity. Considering the high correlation with UDPRS III and PIGD in "ON" states, PCI may be a useful and quantitative parameter to measure the severity of motor symptoms in PD patients who are on medication.ope

APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 1: Clinical Manifestation, Radiologic Examination, Diagnosis Criteria, Classification, and Nonoperative Treatment

Background: Clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies regarding chronic syndesmosis injury remain unclear. Purpose: An international group of experts representing the fields of sports injuries in the foot and ankle area were invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injuries. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 15 clinical questions and statements were related to the clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies for chronic syndesmosis injury and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: Of the 15 questions and statements, 5 reached unanimous support and 10 achieved strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with diagnosis, classification, and nonoperative treatment strategies for chronic syndesmosis injury.ope

APKASS consensus statement on chronic syndesmosis injury

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APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 2: Indications for Surgical Treatment, Arthroscopic or Open Debridement, and Reconstruction Techniques of Suture Button and Screw Fixation

Background: The indications for surgical treatment of chronic syndesmosis injury are challenging for many orthopaedic clinicians, as there is no international consensus on the optimal management of these injuries. Purpose: An international group of experts representing the field of sports injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 9 items with 17 clinical questions and statements were related to indications for surgical treatment, arthroscopic versus open debridement, and suture button versus screw fixation reconstruction techniques and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 17 questions and statements, 4 achieved unanimous support, 11 reached strong consensus, and 2 reached consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical indications and techniques for chronic syndesmosis injury.ope

APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 3: Fusion Techniques, Comorbidity Treatments, Postoperative Rehabilitation, and Return-to-Sport Indications

Background: Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered. Purpose: An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.ope

The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability

Purpose : The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods : We searched PubMed using the index, ""ankle, instability, lateral ligament, reconstruction"" from 1990 to present (September 30, 2015). We excluded 1) modified Br?strom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results : There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >15°, anterior draw >10 mm or the difference of contralateral side talar tilt >5°, anterior draw >3 mm), and 4) overweight (body mass index >30 kg/m2). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion : The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.ope

Preventing SMishing Attack Using Fake User Information Based on Common Behavior of Phishing Websites

학위논문 (석사)-- 서울대학교 대학원 : 전기·컴퓨터공학부, 2014. 2. 조유근.스미싱 공격은 모바일 피싱 공격의 한 유형으로 스마트폰 사용자의 개인정보를 탈취하거나 소액결제 등으로 금전적 피해를 입히는 것을 목적으로 한다. URL이 포함된 메시지로 사용자를 속여 악의적인 웹사이트에 접속을 유도하는 방법으로 최근 피해 사례가 크게 증가하고 있다. 본 논문에서는 스마트폰의 스미싱 공격 방지 기법으로 몇 가지 기법을 합쳐 Phishing URL Detector를 제안한다. 첫 단계에서는 접속할 URL을 분석하여 알려진 피싱 URL 패턴이 포함된 경우 접속을 차단한다. 두 번째 단계로 모바일 웹 브라우저의 북마크와 접속 이력을 기반으로 한 whitelist를 검색해 접속할 URL이 포함돼 있으면 안전한 것으로 간주하고 접속을 허용한다. 세 번째 단계에서는 blacklist를 검색하여 접속할 URL이 포함되어 있으면 위험한 URL로 간주하고 접속을 차단한다. 마지막은 URL의 안전성을 판단할 수 없는 단계이므로 우선 URL에 접속한 뒤 허위 사용자 정보를 입력한 뒤 웹사이트의 동작을 분석하고 피싱 웹사이트인지 판별한다. 이 기법은 입력하는 정보의 유효성을 실시간으로 확인할 수 없고, 모두 입력 되었는지 확인만 가능하다는 피싱 웹사이트의 특징을 이용한다. 따라서, 허위 사용자 정보에도 유효성 검사 후 재입력 요구 없이 다른 동작이 진행된다면 피싱 웹사이트로 판별할 수 있다. URL에 접속해 보기 전에는 피싱 URL 판별이 어렵다는 기존의 문제점을 해결할 수 있는 본 기법은 스미싱 공격을 효과적으로 방지할 수 있는 첫 번째 방어막이 될 수 있다.요약 목차 그림 목차 표 목차 제 1 장 서론 제 2 장 스미싱 공격 2.1 모바일 피싱 공격 2.2 스미싱 공격 2.3 관련 연구 제 3 장 스미싱 공격 방지 기법 3.1 스미싱 공격 특성 분석 3.1.1 스미싱 공격 흐름 분석 3.1.2 스미싱 공격 특징 분석 3.1.3 스미싱 SMS 특징 분석 3.2 Phishing URL Detector 제안 3.2.1 피싱 웹사이트 공통 동작 패턴 분석 3.2.2 Phishing URL Detector 제 4 장 실험 및 구현 4.1 피싱 웹사이트 공통 동작 패턴 확인 실험 4.2 Phishing URL Detector 구현 제 5 장 결론 참고문헌 AbstractMaste

Prognostic Factors after Intra-Articular Hyaluronic Acid Injection in Ankle Osteoarthritis.

PURPOSE: The goal of this study was to identify baseline prognostic factors of outcome in ankle osteoarthritis patients after intra-articular hyaluronic acid injection. MATERIALS AND METHODS: Patients with ankle osteoarthritis who received hyaluronic acid injection therapy were retrospectively reviewed. Each patient received weekly intra-articular hyaluronic acid injections (2 mL) for 3 weeks. Six predictors including gender, age, symptom duration, radiographic osteoarthritis stage, radiographic subchondral cyst, and fracture history were evaluated. Visual analogue scale (VAS) and patient satisfaction were evaluated as outcome measures. These predictors and outcome measurements were included in a logistic regression model for statistical analysis. RESULTS: Total of 40 consecutive patients (21 male, 19 female) were included in this study. Mean age was 60.6. Average follow up period was 13 months. The mean VAS recorded 3, 6, and 12 months after the first injection was 3.6 (SD 2.54, p<0.001), 4.33 (SD 2.9, p<0.001), and 5.3 (SD 2.7, p=0.0071), respectively, when compared to baseline VAS. Early stage disease was identified as an independent predictor associated with 'positive VAS outcome' at 3 and 6 months. Early stage disease and duration of pain less than 1 year were independent predictors associated with higher satisfaction. CONCLUSION: While hyaluronic acid injection for ankle osteoarthritis is a safe and effective treatment, careful selection of patients should be made according to the above prognostic predictors.ope

Development of stabilized dual growth factor-loaded hyaluronate collagen dressing matrix

Patients with diabetes experience impaired growth factor production such as epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), and they are reportedly involved in wound healing processes. Here, we report dual growth factor-loaded hyaluronate collagen dressing (Dual-HCD) matrix, using different ratios of the concentration of stabilized growth factors-stabilized-EGF (S-EGF) and stabilized-bFGF (S-bFGF). At first, the optimal concentration ratio of S-EGF to S-bFGF in the Dual-HCD matrix is determined to be 1:2 in type I diabetic mice. This Dual-HCD matrix does not cause cytotoxicity and can be used in vivo. The wound-healing effect of this matrix is confirmed in type II diabetic mice. Dual HCD enhances angiogenesis which promotes wound healing and thus, it shows a significantly greater synergistic effect than the HCD matrix loaded with a single growth factor. Overall, we conclude that the Dual-HCD matrix represents an effective therapeutic agent for impaired diabetic wound healing.ope